“The balance to fact and analysis is feeling,” our narrative medicine writing instructor informs us. “You’ll find that each poem and essay and story that you write reflects a new aspect of yourself. Be curious about what’s going on. Allow new poems onto the page. Allow free writing in prose and poetry. You have worlds inside you.”

And then, predictably, the homework assignment for next week: “Create and post your ‘800 words.’ The word count is purely there to make writing into the void less intimidation. When we write, we open a portal to our inner life. Joseph Campbell calls it ‘following the echoes of the eloquence within.’ I love that. The challenge lies in trusting those echoes. It is related to trusting intuition. Allow. Allow. Allow. Trust. Trust. Trust. No matter how many classes I’ve taught, no matter how many poems I’ve written, no matter how many books I’ve read: Every single new thing is just that. A new field to move into within myself. I never have any clue what I am doing.”

Clueless. That’s me, too. I’m not good at this stream-of-consciousness thing. But I should be. After all, I am a psychiatrist. I’ve been at this for more than 40 years – listening to my patients’ free associations and reflecting on my own in therapy. And trust. What’s that? Post-pandemic moral injury has all but obliterated trust.

Nevertheless, I am eager to learn more about this free-form process of creative writing and narrative medicine and how to follow my “echoes.” So, I do what comes naturally to me: I research (Google) it. Except I’m told: “No results found for Joseph Campbell’ following the echoes of the eloquence within.'” But Google tells me that Joseph Campbell encourages the audience to discover what excites them, and to make that the basis for their personal journeys. That sounds exactly like what our instructor was trying to tell us.

I then stumble upon similar words of wisdom from Paul Simon. No one writes poems as creatively lyrical as Rhymin’ Simon. “I’m more interested in what I discover than what I invent,” Simon tells American Songwriter, discussing how he crafted “You Can Call Me Al.” Asked what the distinction is between discovery and invention, he explains, “You just have no idea that that’s a thought that you had; it surprises you; it can make me laugh or make me emotional. When it happens and I’m the audience and I react, I have faith in that because I’m already reacting. I don’t have to question it. I’ve already been the audience. But if I make it up, knowing where it’s going, it’s not as much fun. It may be just as good, but it’s more fun to discover it.”

So that’s the key to creative writing! Follow the yellow brick road, the one paved with dreams and aspirations, hopes and failures, love and kindness, betrayal and refuge, levity as well as gravitas. It’s a long and winding road to be sure, maybe one with no terminus, or maybe one that, as our instructor imagines, “lies beyond, within and woven through the anatomy and physiology of life,” adding: “In the words of Dr. Chris Adrian of the Columbia University Narrative Medicine Program, ‘Narrative Medicine begins where medicine ends.'”

Now I am really curious. I follow this thread further in my research. I become immersed in discovery much like Paul Simon. Hell. I am Paul Simon. I am on a father and son journey to Graceland. Simon tells American Songwriter: “The song [Graceland] started to write itself. It became a narrative … and Graceland became more like a metaphor than an actual destination.”

I begin to travel along this metaphorical path. It is a path familiar to purists in the field of literary medicine, those who distinguish between “narrative medicine” and “narrative practice.” Following Simon, I, too, begin to see “angels in the architecture.” They’re “spinning in infinity.” Hallelujah!

There’s one stop remaining on my journey, however. I am at the doorstep of Cat “Yusuf” Stevens, who, like Simon, has set out on a voyage of self-discovery, to clear his mind and see what he can discover “On the Road to Find Out.” Stevens was not writing about traveling in a literal sense but instead bent on finding out who he was and the purpose, if any, of his existence. The last couplet of the song is revelatory:

The answer lies within, so why not take a look now?
Kick out the Devil’s sin, pick up, pick up a good book now.

Narrative medicine and close reading go hand-in-hand. I discovered that narrative medicine emerged in the early 2000s from the medicine and humanities movement that rose to prominence in the 1970s. Narrative medicine is thought of as the discipline of telling stories about illness – indeed, “honoring” the sick and suffering – from multiple perspectives, which culls its pedagogy from the fields of literary studies, film theory, philosophy, anthropology, and social sciences. Narrative practice, on the other hand, encompasses various forms of training that aim to apply narrative ideas and skills to clinical conversations. Putting words on paper is an extension of narrative practice, one that aims to develop narrative practitioners rather than practitioners who have undertaken narrative studies.

I clearly aim to be both – a student of the narrative as well as a practitioner – as I travel on the road to discovery. It’s a road that leads to the creation of meaning and understanding. It’s a road to rejoicing and redeeming. It’s a road that represents the coming together of cultures and genres in a place where everyone is welcome.

This is my pilgrimage. Join me.

Arthur Lazarus is a former Doximity Fellow, a member of the editorial board of the American Association for Physician Leadership, and an adjunct professor of psychiatry at the Lewis Katz School of Medicine at Temple University in Philadelphia, PA. His forthcoming book is titled Every Story Counts: Exploring Contemporary Practice Through Narrative Medicine.